Are patients receiving specialist palliative care thirsty? A qualitative interview study

BACKGROUND: Thirst is a potentially distressing yet under-researched symptom experienced by patients receiving specialist palliative care. Despite its clinical relevance, little is known about how patients experience thirst, or how it is assessed and managed in practice. This may affect patient comfort. This study aimed to describe how patients in specialist palliative home care experience thirst and investigate its impact on their daily lives. DESIGN: A qualitative inductive design. METHODS: Data were collected through semi-structured interviews with 24 patients. The interviews were analysed following the approach of Braun and Clarke's reflexive thematic analysis. This study adheres to the EQUATOR guidelines by using Standards for Reporting Qualitative Research (SRQR). RESULTS: Four main themes were identified describing patients' experiences of thirst in palliative care: (1) the challenge of distinguishing thirst from dry mouth, where patients frequently conflated the two; (2) a persistent symptom in the shadow of others, where thirst was perceived as less significant compared to more distressing symptoms; (3) when thirst is not a priority, reflecting patients' experiences of limited acknowledgement and understanding from healthcare professionals; and (4) always a bottle close, illustrating how patients continuously adapted their daily lives to manage thirst, often without reflecting on its impact. CONCLUSION: Recognising thirst is crucial for both patients and health care professionals, as it can impact the patient's comfort and quality of life, even if its severity is often downplayed compared to other symptoms. Effective recognition and management of thirst, combined with clear communication from health care professionals, can improve patient care.